52 research outputs found
A novel suture technique in the percutaneous repair of Achilles tendon rupture (TANSEL TECHNIQUE)
No full textAim: The aim of this study was to present the clinical results of patients treated with a sliding, wrapping suture technique (Tansel technique) which provides rapid recovery with fewer wound site problems compared to open surgery techniques. Material and Method: A total of 34 patients were included in the study. Following the initial diagnosis made on physical examination, routine dynamic ultrasonography (USG) was applied for the determination of the rupture gap and tendon length. All the patients were evaluated in respect of the time from trauma to surgery, etiological causes, affected side, postoperative AOFAS (The American Orthopaedic Foot & Ankle Score) and Tegner scores, cruris diameter, mean time to full weight-bearing, time of return to work, time to regain pre-trauma activity level and complications. Results: The mean follow-up period was 27.7 +/- 16.8 months. According to clinical evaluations of the patients at the final follow-up examination, postoperative dorsiflexion angle and plantar flexion angle were determined as 16.3 degrees +/- 4.3 degrees, 39.7 degrees +/- 7.1 degrees respectively. While postoperative Tegner score was determined as 87.6 +/- 9, AOFAS score was found as 91.3 +/- 4.7. Postoperatively at sixth months, in the measurements of the cruris area diameter, 1.5 +/- 0.4 cm atrophy was detected. Of the defined major complications, tendon elongation was seen on USG in 1 (2.9%) patient. No re-rupture occurred in any patient. Discussion: Treatment of acute Achilles tendon ruptures with Tansel technique provides successful results such as resolving the problems of re-rupture and tendon elongation particularly in the postoperative tendon malacia stage. So, this technique was considered as an effective technique which could be used to resolve the disadvantages of minimally invasive percutaneous repair
An example of the deep roots of Oğuz Tansel tales: The Blue Bride Tale
No full textDaha çok bir halk efsanesi olarak bilinen Şahmaran hikayesinin kaynakları, yazılı kültürde öncelikle Binbir Gece Masalları'na kadar uzanır. Binbir Gece Masalları M.S. 250 yılı civarı Hint, 500 yılı civarı İran ve 8. yüzyıldan itibaren Arap kaynaklarında görülür. Osmanlı Devleti'nde Dilimize ilk çevirisi (sadece bir bölümü) Câmasbname adıyla 15. yüzyıl şairlerinden Abdî tarafından; son önemli çeviri 1992-1993 yıllarında Âlim Şerif Onaran tarafından Fransızcadan yapılmıştır. Bu makale'de Oğuz Tansel'in 1943-45 tarihlerinde derlediği "Mavi Gelin" masalının motifleri bakımından Binbir Gece Masalları'ndan bugüne geçirdiği değişiklikler ortaya konulmuştur. Tansel fantastik öğelerin yerine, masala gerçekçi olanları yerleştirir. Çıkardığı diğer önemli hususlardan biri de erotik öğelerdir: Kahramana vaad edilen bin altın ödülün yanında bakire yoktur ya da havuzda yüzen kızlarla cilveleşme yoktur. Çocuk aklıyla tuzağa düşmenin nedeni, bir işin sonunu düşünememe durumudur. Sarayın yerini konak almıştır; Hz. Süleyman'ın bina ettiği Kuşlar Tekkesi'nin bekçisi normal bir konak sahibi oluverir, kuşları değil, kardeşini ziyaret için konaktan ayrılır. Yasak bahçede yakuttan taht yerine bol çiçekli bir bahçe ve havuz vardır. Ak güvercinler soyunmaz, çırpınıp kılık değiştirirler vs. En önemli değişiklik olarak, Binbir Gece Masalları'nda ya da Şahmaran'da kızın ölümünden dolayı ortaya çıkan mutsuz son kaldırılmış, bunun yerine Türk masallarında sık görülen mutlu son ikame edilmiştir. Masal kahramanının merakı uğursuzlukla, eşinin ölümüyle cezalandırılmaz. Oğlanın başına gelenler her ne kadar cahaletinden de olsa, sözü ve gözü pekliği, korkusuzluğu övülür. Sonuç olarak, eski olağanüstü masal ve efsane motifleri Mavi Gelin masalında çağımıza uygun olarak daha gerçekçi bir nitelik kazanmıştır.The sources of Şahmaran, mostly known as a popular legend, primarily go back to 'A Thousand Arabian Nights' in the culture of literature. 'A Thousand Arabian Nights' has been seen in Indian sources approximately for 250 A.D., Persian sources since 500 A.D. and Arabic sources since 8th century A.D. In Ottoman Empire, its first translation (only a part of it) to our language was made by Abdî, a writer from 15th century, with a name Câmasbname; and the last remarkable translation was made from French by Âlim Şerif Onaran in 1992-1993. This article shows the changes that the Blue Bride tale collated by Oğuz Tansel in 1943-45 has been undergoing since 'A Thousand Arabian Nights' in terms of its themes and patterns. Tansel added realistic elements to the tale instead of fantastic ones. Another elements that he removed are erotic items: The gift promised to the hero does not include virgin girls, or there is not any dalliance with women swimming in the pool. Falling into the trap is resulted from not being able to predict the end of actions. The palace has been replaced by the mansion; the gatekeeper of the Kuşlar Tekkesi (a kind of Islamic monastery) builded by the Prophet Suleiman has been transformed into an ordinary mansion owner, and the story has changed that he lefts the mansion in order to visit his brother. There are a lot of flowers and a pool in the forbidden garden, instead of a throne made of ruby. White pigeons do not get undressed, they flutter and masquerade instead. As the most important change, the unhappy ending which takes part in Sahmaran or The Arabian Nights: One Thousand and One Nights caused by the death of the girl has been removed; and a happy ending which is commonly seen in Turkish tales has been added. The curiosity of the tale character is not punished by his wife’s death. Although all the things happened were because of his ignorance; his courage, honesty and faith are praised. As a result, supernatural patterns seen in legends and tales have become more realistic in accordance with our modern age
The most common patient-related factors in hip dislocations following total hip replacement
No full textTotal diz replasmani uygulanan steril hazir turnike ile pnömotik turnikenin ameliyat sonrasi dönemde derin ventrombozu oluşumu yönünden karşilaştirilmasi
No full textAMAÇ: Total diz replasmanında kullanılan steril elastikhazır turnike ile pnömotik turnikenin ameliyat sonrasıdönemde gelişebilen derin ven trombozu oluşumuna etkisiniincelemek ve sonuçlarını bildirmek.GEREÇ VE YÖNTEM: 2005-2012 yılları arasında total dizreplasmanında (TDR) uygulanan 754 hasta çalışmayaalındı. Hasta sayısı, cinsiyet ve ağırlıkları göz önündebulundurularak 2 ayrı grup oluşturuldu. 1. gruptaki 377vakaya pnömotik turnike, 2. gruba aynı sayıda hazır sterilturnike kullanıldı. Her iki grup pıhtılaşmayı etkileyenbiyokimyasal değerler yönünden incelendi. Pıhtılaşmayaetkileyen ilaç kullanımı, faktör eksikliği, geçirilmiş derinven trombozu veya riskine sahip hastalar çalışmayaalınmadı. Tüm hastalara aynı cerrahi grup tarafındanoperasyon gerçekleştirilmiş olup ortalama operasyonsüresi 60,2±4,12 (45-100) dakika olarak tespit edildi. Tümhastalar ortalama19,5±2,18 (10-28) saat sonra mobilizeedildi, motor blok bitiminde ayak fleksiyon-ekstansiyonhareketleri uygulatıldı. Hastalar ortalama 5,14±0,92 (3-9) gün hospitalize edildi. Taburcu sonrası 1-4. haftalardakontrole çağrıldı. Bu süre zarfında hastalar derin ventrombozu açısından klinik ve ultrasonografik olarak altekstremite venöz doppler tetkiki uygulandı. Derin ventrombozu (DVT) pozitif olan hastalara Kardiyovaskülercerrahi tarafından tedavi başlandı.BULGULAR: İncelenen 754 hasta içinde 165’ inde (%21.8)DVT tespit edildi. Bunlardan 1. grupta 124 (%32.8) 2.grupta ise 41(%10.8) di. Pulmoner emboli 21 (%2.7)hastada teşhis edilirken 1. grupta 19 (%5) 2. gruptaise sadece 2 (%0.5) hastada saptandı. İki grup DVT vepulmoner emboli gelişimi açısından anlamlı bulundu.(p<0.05). Her iki grupta incelenen demografik özelliklerbenzerdi.SONUÇ: Pnömotik turnike uygulanması esnasında altextremitede yaklaşık 30-40 cm lik bir segmentte sirkülerkompresif güçlere bağlı spazm oluşmaktadır, bunakarşılık hazır steril turnikede bu genişlik yaklaşık 2 cmdir. Etki altında kalan segment uzunluğu arttıkça damarintimasında olası hasarlanma nedeniyle venöz trombozriskinin artabildiği görülmektedir. Hazır steril turnikelerinDVT açısından daha az riskli olduğu görülmektedir
A performance evaluation study of thin-wall tube design in the front bumper uses the altered TOPSIS-rank order clustering algorithm-integrated approach
No full textThe rising growth of the economy in developing countries led to a significant increase in the number of vehicles on the roads. The number of vehicles in road transport is also increasing significantly due to the increase in automobile ownership due to the increase in city populations. As a result of this increase, there is an increase in traffic accidents. For this reason, automobile manufacturers make significant efforts to develop lighter and more robust bumpers. Also, they used performance measurement studies for the thin-walled bumpers. The motivation of the study is based on the examines the dynamic performance of thin-walled bumpers within the impact of both oblique and axial compression. The crash performance of thin-wall tubes is analyzed based on factors such as speed, mass, and cross-section geometries. We developed a new rank order clustering (ROC) algorithm that integrated altered technique for order preferences by similarity to ideal solution (A-TOPSIS) method-based comparative analysis to determine the best thin-wall tube among the alternatives. For the first time in the literature, the A-TOPSIS results-integrated ROC algorithm is proposed to obtain the best tube profiles considering different expectations from their performance according to the determined criteria.Please check and confirm the edi t in the article title.OK.Please confirm if the author names are presented accurately and in the correct sequence (given name, middle name/initial, family name). Author 2 Given name: [Yusuf Tansel] Last name [Ic] and Author 4 Given name: [Bekir Batuhan] Last name [Sagol]. Also, kindly confirm the details in the metadata are correct.O
EARLY BLOOD TRANSFUSION MAY PREVENT POSTOPERATIVE COGNITIVE DYSFUNCTION AFTER HIP ARTHROPLASTY IN ELDERLY PATIENTS
No full textIntroduction: The number of joint arthroplasties in the elderly continues to increase with the increase in elderly population. Postoperative cognitive dysfunction is an important complication after surgery in elderly patients. However, the exact cause of postoperative cognitive dysfunction and factors contributing to its development remain unknown. We aimed to determine whether blood loss during or after surgery and the approach for the replacement of this loss affected postoperative cognitive dysfunction frequency and duration. Materials and Method: A prospective study of elderly (>75 years) patients who underwent total/partial hip arthroplasty due to femoral neck or intertrochanteric fractures was conducted. Patients were randomised into two groups. The first group underwent transfusion when haemoglobin values reduced below 9.0 mg/dL, whereas the second group underwent earlier blood transfusion according to the volume of blood loss during and after surgery. All groups were similar in terms of factors considered to be associated with postoperative cognitive dysfunction. An experienced neurologist assessed patients' cognitive functions using the Standardized Mini-Mental Status Examination test and clinical examinations pre- and postoperatively. Results: In total, 48 patients in the first group and 13 in the second group (early intervention group) were diagnosed with postoperative cognitive dysfunction. The duration of cognitive dysfunction was significantly lower in the second group (10.8 +/- 1.2 vs. 8.9 +/- 1.5 days; p<0.001). Conclusion: Although the causal relationship between blood loss and postoperative cognitive dysfunction has not been elucidated in this study, our results demonstrate that postoperative cognitive dysfunction frequency and duration may be reduced by early replacement of blood loss in elderly patients who undergo total/partial hip arthroplasty
Comparsion of deep venous thrombosis between using ready to use sterile tourniquet and pneumatic tourniquet at total knee arthroplasty surgery
No full textAMAÇ: Total diz replasmanında kullanılan steril elastik hazır turnike ile pnömotik turnikenin ameliyat sonrası dönemde gelişebilen derin ven trombozu oluşumuna etkisini incelemek ve sonuçlarını bildirmek.
GEREÇ VE YÖNTEM: 2005-2012 yılları arasında total diz replasmanında (TDR) uygulanan 754 hasta çalışmaya alındı. Hasta sayısı, cinsiyet ve ağırlıkları göz önünde bulundurularak 2 ayrı grup oluşturuldu. 1. gruptaki 377 vakaya pnömotik turnike, 2. gruba aynı sayıda hazır steril turnike kullanıldı. Her iki grup pıhtılaşmayı etkileyen biyokimyasal değerler yönünden incelendi. Pıhtılaşmaya etkileyen ilaç kullanımı, faktör eksikliği, geçirilmiş derin ven trombozu veya riskine sahip hastalar çalışmaya alınmadı. Tüm hastalara aynı cerrahi grup tarafından operasyon gerçekleştirilmiş olup ortalama operasyon süresi 60,2±4,12 (45-100) dakika olarak tespit edildi. Tüm hastalar ortalama19,5±2,18 (10-28) saat sonra mobilize edildi, motor blok bitiminde ayak fleksiyon-ekstansiyon hareketleri uygulatıldı. Hastalar ortalama 5,14±0,92 (3- 9) gün hospitalize edildi. Taburcu sonrası 1-4. haftalarda kontrole çağrıldı. Bu süre zarfında hastalar derin ven trombozu açısından klinik ve ultrasonografik olarak alt ekstremite venöz doppler tetkiki uygulandı. Derin ven trombozu (DVT) pozitif olan hastalara Kardiyovasküler cerrahi tarafından tedavi başlandı.
BULGULAR: İncelenen 754 hasta içinde 165’ inde (%21.8) DVT tespit edildi. Bunlardan 1. grupta 124 (%32.8) 2. grupta ise 41(%10.8) di. Pulmoner emboli 21 (%2.7) hastada teşhis edilirken 1. grupta 19 (%5) 2. grupta ise sadece 2 (%0.5) hastada saptandı. İki grup DVT ve pulmoner emboli gelişimi açısından anlamlı bulundu. (p<0.05). Her iki grupta incelenen demografik özellikler benzerdi.
SONUÇ: Pnömotik turnike uygulanması esnasında alt extremitede yaklaşık 30-40 cm lik bir segmentte sirküler kompresif güçlere bağlı spazm oluşmaktadır, buna karşılık hazır steril turnikede bu genişlik yaklaşık 2 cm dir. Etki altında kalan segment uzunluğu arttıkça damar intimasında olası hasarlanma nedeniyle venöz tromboz riskinin artabildiği görülmektedir. Hazır steril turnikelerin DVT açısından daha az riskli olduğu görülmektedir.OBJECTIVE: We aimed to compare the incidence of deep vein thrombosis (DVT) after total knee arthroplasty with the use of sterile elastic tourniquet and the pneumatic tourniquet.
MATERIAL AND METHODS: From 2005 to 2012, 754 patients undergoing Total knee prosthesis (TKP) were included in this study. Two groups have been formed considering patient number, sex and weight. At the first group, 377 patients have been operated using pneumatic tourniquet. Sterile tourniquet was also used in 377 patients at the second group. Both groups were evaluated for biochemical tests which related to clotting. Patients showing preoperative DVT or receiving anticoagulants were excluded. Patients with known factor deficiency were also excluded from this study. All patients were operated by same surgeon group and mean operation time was 60 (45-100) minutes. All of the patients were mobilised after 19 (10-28) hours. Ankle flexion and extension exercises was performed after following motor block. Mean hospitalization time was 5 (3-9) days. Patients were controlled in the first and fourth weeks after discharge from the hospital. During this time, patients have been evaluated with clinical findings and lower extremity doppler ultrasonography for DVT. Patients who had developed DVT, have been treated by cardiovascular surgery department.
RESULTS: 165 (21.8%) of the 754 patient had DVT. 124 (32.8%) of these patients was in the first group and 41 (10.8%) was in the second group. 21 (2.7%) patients had pulmonary embolism, 19 (5%) patients were in the first group and 2 (0.5%) of these were in the second group. We observed a significant difference between the groups, with a frequency of DVT and pulmonary embolism. (p<0.05). Demographic characteristics were similar in both groups.
CONCLUSIONS: When pneumatic tourniquet was used, spasms had been developed in 30-40 centimeter segment at lower extremity because of circular compressive forces. On the other hand, this segment was only two centimeters when sterile tourniquet was preferred. When affected segment was larger, increasing venous thrombosis risk were shown because of venous intima damage. We thought that the use of a sterile tourniquet decreased the incidence of DVT
Karpal tünel sendromu dekompresyon cerrahisinde diyabetes mellitus’un sonuçlara etkisi
No full textAmaç: Kiniğimizde Karpal Tünel Sendromu (KTS) nedeniyle cerrahi olarak müdahale edilenlerininsonuçlarının diyabetes mellituslu (DM) olup olmamaya göre karşılaştırılması.Materyal ve Metot: 2009?2013 yılları arasında Karabük Üniversitesi Tıp Fakültesi Eğitim AraştırmaHastanesi Ortopedi ve Travmatoloji Kliniği’ne başvuran KTS tanısı almış hastalar bu retrospektifaraştırmanın çalışma grubunu oluşturdu. Çalışma grubu 3 ayrı gruba ayrıldı; DM teşhisi olmayan grup(Grup 1, n=50), DM teşhisi olup polinöropatisi bulunmayan grup (Grup 2, n=45), DM teşhisi oluppolinöropatisi olan grup (Grup 3, n=28). Hastaların semptomları operasyon öncesi ve sonrasıkaydedilerek karşılaştırmalar yapıldı.Bulgular: Çalışmamızdaki gruplar yaş, cinsiyet, eğitim durumu, semptomların dağılımı açısındanameliyat öncesinde benzer bulundu. Hastaların semptomlarının son bir yıl içerisindeki değişimleriincelendiğinde, ağrı sempromunun Grup 1 (p=0,001) ve Grup 2’de (p=0,004) anlamlı seviyede azaldığıgörülürken, Grup 3’te (p=0,581) değişmediği görüldü. Parestezi semptomunun, Grup 1 (p=0,001) ve Grup2’de (p=0,017) anlamlı seviyede azaldığı görülürken, Grup 3’te (p=0,344) değişmediği görüldü. Ayrıca,güçsüzlük semptomunun Grup 1’de (p=0,029) anlamlı seviyede azaldığı izlenirken, Grup 2 (p=0,064) veGrup 3’te (p=0,057) değişmediği izlendi.Sonuç: Çalışmada DM teşhisli hastaların polinöropatisinin olup olmamasının KTS sonucuna anlamlıderecede etki ettiğini izlenmiştir. Operasyon öncesinde ve sonrasında kişiler DM’li olsalar bile nöropatidüzeylerinin izlemi yararlı olabilir
Multiplexed thermal-diffusivity-based temperature sensors
No full textDue to the precise lithography and highly pure silicon used in IC technology, thermal-diffusivity (TD) temperature sensors can achieve high accuracy without the need for trimming. TD sensors employ electrothermal filters (ETFs) to measure the thermal diffusivity of silicon, i.e. the rate at which heat diffuses through silicon, which is a well-defined function of temperature. This thesis presents two approaches to improve the accuracy and resolution of TD sensors. The first approach investigates the effect of variations in ETF geometry on sensor resolution and proposes a multiplexing scheme to utilize a single readout circuit for reading out multiple ETFs. The second approach aims to investigate the effect of improvements in CMOS technology on sensor accuracy by scaling two ETFs to the 65nm process from the 180nm process. A first-order phase-domain delta-sigma modulator is designed for the readout of the ETFs in the 65nm process, and the previously designed multiplexing scheme is used for cost and time-efficient tape-out. Based on the estimated lithographic error of the 65nm process, the two ETFs are expected to achieve untrimmed inaccuracies of 0.18℃(3𝜎) and 0.36℃(3𝜎), respectively.Electrical Engineerin
The Effect of Hormone Replacement Therapy on Postmenopausal Sternoclavicular Joint Arthritis
No full textAim: To investigate the effect of hormone replacement therapy on the treatment of postmenopausal sternoclavicular joint (SCJ) arthritis. Material and Method: This cross-sectional study included postmenopausal female patients who presented with complaints of pain and swelling in the SCJ at the Orthopaedics Polyclinic of Karabuk University Training and Research Hospital between September 2014 and September 2016. After the imaging and laboratory tests required for evaluation by an orthopaedic specialist, the patients were referred to the Gynaecology Department for evaluation in respect of postmenopausal symptoms and hormone replacement therapy (HRT). For those with indications, HRT was started. The treatment protocol for SCJ arthritis was applied to all patients by the orthopaedics specialist. The patients were separated into two groups: those receiving HRT (Group 1) and those not receiving HRT (Group 2). The sociodemographic and clinical characteristics and laboratory test results were recorded for all patients. All the patients were evaluated by the orthopaedic specialist at the 1st, 3rd, 6th, and 12th month of treatment using the Rockwood Scale (RS) and the Visual Analog Scale (VAS) for pain. Results: A total of 92 patients met the study criteria and were included for evaluation. As 13 patients did not attend follow-up examinations, they were excluded and the study was completed with 79 patients. Group 1 comprised 38 patients who started HRT on the recommendation of the Gynaecology Department and Group 2 comprised 41 patients who were not taking HRT. The mean age of patients was 52.6 +/- 5.2 years in Group 1 and 54.1 +/- 4.8 years in Group 2. No statistically significant difference was determined between the groups in respect of age, imaging, and laboratory test results (p>0.05). The need for non-steroid anti-inflammatory drugs and intraarticular injection was statistically significantly lower in Group 1 compared to Group 2 (p=0.012, p=0.006 respectively). No difference was determined between the groups in respect of the VAS scores evaluated preoperatively and at 1 month of treatment (p=0.712, p=0.579, respectively). In Group 1, the VAS scores at 3 months (p=0.038), 6 months (p=0.0213), and 9 months (p<0.001) were determined to be statistically significantly lower than those of Group 2. The RS values of both groups were similar preoperatively and at 1 month (p=0.897, p=0.789, respectively), while the results of Group 1 were statistically significantly higher at 3 months (p=0.034), 6 months (p=0.0212), and 9 months (p=0.0392). At the end of 1 year, the results of both VAS and RS were similar in the two groups (p=0.676, p=0.867, respectively). Discussion: The results of this study showed that with the application of HRT when there were indications, postmenopausal SCJ arthritis was less symptomatic, improved in a shorter time, and required fewer tests and less medication
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